Temporal Trends and Predictors of Thirty-Day Readmissions and Emergency Department Visits Following Total Knee Arthroplasty in Ontario Between 2003 and 2016
Temporal Trends and Predictors of Thirty-Day Readmissions and Emergency Department Visits Following Total Knee Arthroplasty in Ontario Between 2003 and 2016
复制标题
DOI：
10.1016/j.arth.2019.09.015
复制
发表时间：
2020-02-01
影响因子：
3.5
通讯作者：
Ward, Sarah E.
中科院分区：
文献类型：
--
作者：
Ross, Tayler D.;Dvorani, Erind;Ward, Sarah E.
背景：全膝关节置换术（TKA）是加拿大第二常见的手术。了解和改进与此类大批量手术相关的质量指标对于最大化医疗保健系统内的价值至关重要，这是成本和质量之间的平衡。尽管之前已经在私有化医疗机构中描述了 TKA 后再入院和急诊科 (ED) 就诊的比率和预测因素，但很少有研究评估通用单一付款人系统中 TKA 后住院时间 (LOS)、再入院和 ED 就诊的趋势。方法：使用来自省级保存和验证的注册中心临床和评估科学研究所的数据，我们对在加拿大安大略省进行的所有 205,152 例 TKA 进行了审查， 2003 年至 2016 年间。我们确定了利用率、LOS、再入院和急诊就诊的时间趋势，并使用多元逻辑回归模型评估了患者和提供者对医院再入院和急诊就诊的预测因素。我们还根据现有的国际疾病分类、第九版和第十版编码信息对再入院和急诊就诊的最常见原因进行了分组和描述。结果：在研究期间，LOS 显着下降（P
Background: Total knee arthroplasty (TKA) is the second most common surgery performed in Canada. Understanding and improving quality metrics associated with such high-volume procedures is of utmost importance to maximize value within the healthcare system, which is a balance between cost and quality. Although rates and predictors of hospital readmission and emergency department (ED) visits following TKA have previously been described in privatized healthcare settings, few studies have evaluated trends in length of stay (LOS), hospital readmissions, and ED visits following TKA in a universal single-payer system.Methods: Using data from a provincially held and validated registry, the Institute for Clinical and Evaluative Sciences, we undertook a review of all 205,152 TKAs performed in the province of Ontario, Canada, between 2003 and 2016. We determined temporal trends in utilization, LOS, readmissions, and ED visits and evaluated patient and provider predictors of hospital readmissions and ED visits using multivariate logistic regression modeling. We also grouped and described the most common reasons for readmission and ED visits based on the available International Classification of Diseases, Ninth Revision and Tenth Revision coding information.Results: LOS decreased significantly over the study period (P